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APPLICATION�„� FOR GONSTRUCT�,�N PERMIT �� <br /> TO BE CC.�.�PLETED IN BLACK INK—PLEASE PRIN i <br /> HEATING SYSTEM. GAS ❑ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �1 DEMOLITION i_' COMBINATION i BUILDING �+-MECHANICAL �1 PLUMBING �_� SIGN ` <br /> ��'�(�llf��X•\\ �(�vRi�c��-, � Y ��15 �"�c�.� �v� ��, F �����3 �� - (r7G�v <br /> TENANT MnIlAU0PE55 CITY ZIP �—PHONE <br /> � <br /> ANCJHJLECTOF ESIGNER MAILADDRE55 C�TV Z�P PHONE <br /> 1 u� <br /> GENERRLCOiT�ON MAILADDRE55 Lliv 21P PnONE STpTEUCENSEa <br /> � � <br /> M�ECHNI�C�LCONT'g�\CTOR MRILADORE55 CITV EIP PMONE �iATELICENS_� <br /> `.�. � � 1 \11� `� <br /> z u;�y PlUMBINb CONTRACTOR MAIL A��RE55 GTY 21P PHONE STATE UCEN;E Y <br /> s � y CON�T PRi E OF WOFK <br /> r' � �C�-�.Ci=-� <br /> N � '�' <br /> F] H OESCRIBEWORNANOSOUAPEFOpT�GE�NVOLVEO CONTRCiPER50NRNDPNONENO <br /> � H � <br /> �y �a , . �� .�c c � ,�,A� [�;,1C.,� <br /> ,yT, "'1 3 I HEREBV CERTIFY THAT I HAVE READ ANO EXAA7INED THIS <br /> �r� � d PROPOLEDUSEOFOURDING APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> O N �1-- �� PROVISIONS OF LAWS AN�ORDINANCES GOVERNING THIS NPE OF <br /> H �q g �ea�oe5ca�vrroNorraoaca�vis�owHee�owonnTucH*wocoo�esi WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> x M � l0T — BIOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � y x _ OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> �"� �7 OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> gy APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> H <br /> O� W PRRCELTPX I D.NUTABEA CONTRACTORS LAIN 1827 RCW AND 296.200 WAC. <br /> �y [�[�x� ['� , /� <br /> p7 t�1 CONSTPUCTIONIO�NLEN�ER.A0DAE55.TELEFHONENUMOER Q� /[ <br /> 2�' H tn X � (��r��il.� ��iC�0.�''I,G l'1�f.J S�'-J��� <br /> � � PROJECT DFEtSS � ,�\ sG"•'u o E <br /> �1 '"Y 1 C\�+L f l � c�..o�sn�cssicc.�seHo <br /> PLUMBING MECHANICAL <br /> � N0. TVPE OF FI%TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> � WATER CLOSET(TOILET) __ A C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.TU. M E.A. <br /> I �� LAVATORV(WASN BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DAYERS <br /> � KITCH=N SINK 8 DISP VENTILl�TION FAN <br /> ' DISHN'ASHER RANGE HOOD <br /> I �� LAUNC7RY TRAY _ _ WATER HEATER <br /> CLOTFIES WASHER WOOD STOVE <br /> �, URINAL METAL FIREPIACE(WOOD BURNWG) <br /> DRINKING FOUNTAIN FIREPLACE INSEFT <br /> FLOOFi�RAIN HEAT PUMP ' <br /> �I ��' BACKf°LOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ' � '����`� _ <br /> '��� __ i <br /> � -•1 <br /> SUBTOTAL $ SUBTOTAL S <br /> ��, PERMIT 5 PERMIT 5 <br /> TOTALFEE 5 ' TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONTSEiBACN REPRSETBACN S��ESETBApN PUNCnECKNU�AB[A FEE FECEIPTNO <br /> USEzonE totneEn V�CANTSITE FEES VALUATION FEE <br /> ❑ YES .� NO BUILDING <br /> fYPEOFCON51 NOOFSTORiES ttmwn:r �OO�CxRu'.Gcti��S <br /> "9�p° PLUh101NG <br /> SREOFBL00. FlRESPRiHKLER5RE0'0 B�SEMENT MECHANICAL <br /> C YES NO <br /> OCCUPANCYLOAD FIREAUHMRE00 HEIGNTUMITqT10N ADOITIONALPLANCMECK <br /> OTHER • <br /> �� <br /> REASON <br /> STATE BUILDING SURCHARGE <br /> INTANEBY PL�NSAPPROVEOBV CITYOFEVERETT PUBLICWORKS <br /> LOCALSALES <br /> o„tE TAX CODE IS 3105 TOTAL <br />